Dataset Information

Drinking Water Uranium and Potential Health Effects in the German Federal State of Bavaria.

ABSTRACT: Mainly due to its nephrotoxic and osteotoxic potential, uranium (U) increasingly finds itself in the spotlight of environmental and health-related research. Germany decided on a binding U guideline value in drinking water of 10 µg/L, valid since 2011. It is yet widely unknown if and how public health was affected by elevated U concentrations before that. In this ecological study we summarized available drinking water U data for the German federal state of Bavaria (703 analyses in total for 553 different municipalities) at county level (for 76 out of 96 Bavarian counties, representing about 83% of Bavaria's and about 13% of Germany's total population) in terms of mean and maximum U concentration. Bavaria is known to regionally exhibit mainly geogenically elevated groundwater U with a maximum value of 40 µg/L in the database used here. Public health data were obtained from federal statistical authorities at county resolution. These included incidence rates of diagnosed diseases suspected to be potentially associated with chronic U uptake, e.g., diseases of the skeleton, the liver or the thyroid as well as tumor and genito-urinary diseases. The datasets were analyzed for interrelations and mutual spatial occurrence using statistical approaches and GIS as well as odds ratios and relative risks calculations. Weak but significant positive associations between maximum U concentrations and aggregated ICD-10 diagnose groups for growths/tumors as well as liver diseases were observed, elevated incidence rates of thyroid diseases seem to occur where mean drinking water U concentrations exceed 2 µg/L. Here, we discuss obtained results and their implications for potential impacts of hydrochemistry on public health in southeast Germany.

SUBMITTER: Banning A

PROVIDER: S-EPMC5580629 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Drinking Water Uranium and Potential Health Effects in the German Federal State of Bavaria.

Banning Andre A Benfer Mira M

International journal of environmental research and public health 20170818 8

Mainly due to its nephrotoxic and osteotoxic potential, uranium (U) increasingly finds itself in the spotlight of environmental and health-related research. Germany decided on a binding U guideline value in drinking water of 10 µg/L, valid since 2011. It is yet widely unknown if and how public health was affected by elevated U concentrations before that. In this ecological study we summarized available drinking water U data for the German federal state of Bavaria (703 analyses in total for 553 d ...[more]

PMID: 28820453

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Project description:BackgroundThe provision of high-quality medical care to asylum seekers represents a key challenge in many countries of the European Union. Especially continuity of care has been difficult to achieve as the migrant trajectory moves asylum seekers across and within European countries. Patient-held personal health records (PHR) have been proposed to facilitate the transfer of medical history between health sectors and providers, but so far there is no data to support its use in the migrant setting. The present paper addresses this knowledge gap by exploring the experiences and practices of healthcare providers in reception centers for asylum seekers using a patient-held PHR as well as the perceived associated benefits and shortcomings.MethodsEarly evaluation by means of a multi-sited qualitative study in six asylum seeker reception centers in five cities in the German state of Baden-Wuerttemberg, conducted between November 2016 and January 2017. The PHR evaluated in this study was implemented in five of these reception centers between February and October 2016; the remaining one only receiving patients with the PHR through transfer from the other facilities. 17 interviews were conducted with physicians and nurses working at these reception centers exploring their experiences, routines, and perspectives regarding the patient-held PHR. The interviews were recorded, transcribed and analyzed following the approach of thematic analysis.ResultsHealthcare providers recognise the potential of a patient-held PHR to improve access to medical history. They use the PHR to document their medical consultations and to collect other medical reports. However, physician adherence to the patient-held PHR was described as unsatisfactory, in particular among external doctors, thus limiting its immediate benefit. Reasons given for this low adherence included lack of information before implementation, demanding working conditions with little support, low perceived benefits depending on the degree of fragmentation of settings, parallel existence of other documentation platforms and strained patient relationships.ConclusionA patient-held PHR could improve the availability of health-related information in reception centers if a context-sensitive implementation process achieves high adherence to the PHR among physicians as well as high patient compliance and includes guidelines regarding its adequate integration into local routines.

Project description:While adult exposure to PCE is known to have toxic effects, there is little information on the long-term impact of prenatal and early childhood exposure. We undertook a retrospective cohort study to examine the effects of their early life exposure to PCE-contaminated drinking water. This retrospective cohort study examined whether prenatal and early childhood exposure to PCE-contaminated drinking water influenced the risk of a variety of chronic conditions among adults who were born between 1969 and 1983 in the Cape Cod area of Massachusetts.Eight hundred and thirty-one participants with prenatal and early childhood PCE exposure and 547 unexposed participants were studied. Individuals completed questionnaires to gather information on demographic characteristics, chronic conditions, and other sources of solvent exposure. The location of residences from birth through 1990 were used to estimate PCE exposure with U.S. EPA's water distribution system modeling software (EPANET) modified to incorporate a leaching and transport model.No associations were observed between early life PCE exposure and current occurrence of obesity, diabetes, cardiovascular disease, hypertension, color blindness, near- and far sightedness and dry eyes. In contrast, a 1.8-fold increased risk of cancer (95% CI: 0.8, 4.0) was seen among individuals with any early life exposure. These results were based on 31 participants (23 exposed and 8 unexposed) who reported cancers at a variety of anatomical sites, particularly the cervix. A 1.5-fold increase in the risk of epilepsy (95% CI: 0.6, 3.6, based on 16 exposed and 7 unexposed participants) was also observed among individuals with any early life exposure that was further increased to 1.8 (95% CI: 0.7, 4.6) among those with exposure at or above the sample median.These results suggest that the risk of epilepsy and certain types of cancer such as cervical cancer may be increased among adults who were exposed to PCE-contaminated drinking water exposure during gestation and early childhood. These findings should be interpreted cautiously because of the study limitations and confirmed in follow-up investigations of similarly exposed populations with medically-confirmed diagnoses. This relatively young study population should also be monitored periodically for subsequent changes in disease risk.

Dataset Information

Drinking Water Uranium and Potential Health Effects in the German Federal State of Bavaria.

Publications

Drinking Water Uranium and Potential Health Effects in the German Federal State of Bavaria.

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